For nocturnal leg cramps, only when cramps cause regular disruption of sleep, when cramps are very painful or frequent, when other treatable causes of cramp have been ruled out; and when nonpharmacological measures have not worked (e.g. passive stretching exercises)
Quinine is not a routine treatment for nocturnal leg cramps, and should only be considered when cramps cause regular disruption of sleep. Quinine should only be considered: when cramps are very painful or frequent; when other treatable causes of cramp have been ruled out; and when nonpharmacological measures have not worked (e.g. passive stretching exercises). After an initial trial of 4 weeks, treatment should be stopped if there is no benefit.
Please note : Quinine can cause QT interval prolongation
| Pack | Price |
|---|---|
| 28 tablet | £2.79 |
Baclofen Tablets and Oral Solution SF
MS – Spasticity
CSM Warning: Serious side effects can occur on abrupt withdrawal. To minimise risk, discontinue by gradual dose reduction over at least 1 to 2 weeks (longer if symptoms occur).
NICE NG220 Multiple sclerosis in adults: management
Brands: Lioresal, Lyflex, Gablofen (prescribe generically)
| Pack | Price |
|---|---|
| 84 tablet | £1.29 |
| Pack | Price |
|---|---|
| 300 ml | £3.06 |
MS - Spasticity
Liver function tests should be carried out in all patients before and during treatment. Potentially life-threatening hepatotoxicity has been reported, although usually with doses greater than 400mg daily.
Counselling:
Patients should be told how to recognise the signs of liver disorder and advised to seek medical attention if symptoms such as anorexia, nausea, vomiting, fatigue, abdominal pain, dark urine or pruritus develop.
NICE CG186 Management of MS in Primary & Secondary Care
| Pack | Price |
|---|---|
| 100 capsule | £43.07 |
| Pack | Price |
|---|---|
| 100 capsule | £16.87 |
MS - Spasticity
Rationale 1,2,8
NICE NG220 Multiple sclerosis in adults: management
NICE NG144 Cannabis-based medicinal products
Neuromuscular Disorders
Liver function tests should be carried out in all patients before treatment and then monthly for the first four months and in those who develop symptoms suggestive of liver dysfunction.
| Pack | Price |
|---|---|
| 120 tablet | £5.02 |
| Pack | Price |
|---|---|
| 120 tablet | £10.71 |
Short-term symptomatic relief of muscle spasm
Rationale 1
| Pack | Price |
|---|---|
| 100 tablet | £20.25 |
| Pack | Price |
|---|---|
| 100 tablet | £5.17 |